Category: Diseases and Disorders

Crohn’s Disease Dietary Restrictions and Natural Remedies

Posted on by Michael Brown

Crohn’s disease is an inflammatory bowel disease (IBD) resulting in chronic inflammation of the gastrointestinal tract.  IBD encompasses Crohn’s disease and ulcerative colitis.   Crohn’s disease is associated with distinct granulomas and inflammation which may also affect lymph nodes.1

Ulcerative colitis is a milder disease that is characterized by continuous inflammation affecting the colon.  Both of these conditions lead to extensive epithelial damage.

Inflammatory bowel disease may cause a variety of symptoms including:

  • Loss of appetite
  • Fever
  • Weight loss
  • Diarrhea which may contain blood
  • Abdominal pain and cramping
  • Anemia due to blood loss
  • Urgency to defecate

I thought I would write a post on ways to combat this disease other than the traditional medication therapy. 

Remember, if you suffer from IBD, it is important to visit your physician on a regular basis.  Since bleeding and GI blockages are possible, tests may need to be performed by a professional to keep you as healthy as possible. 

You may require medication depending on how severe your symptoms are.  This disease may also cause a decrease in the absorption of vital vitamins and nutrients the body needs for proper functioning. 

The recommendations in this article should only be considered in combination with the advice of a physician.  I am a strong advocate of yearly check-ups.  Preventative medicine is vital to health.

What Foods Cause Crohn's Disease Flare-ups

Although there is no particular diet that has been scientifically proven to prevent inflammatory bowel disease, there are some trigger foods that may cause flare-ups.  My advice is to keep a food journal and this should help you determine which foods tend to cause problems.  If you find a certain food or food group appearing often before flare-ups, you may consider eliminating that item from your diet.  Some of the possible “problem items” include:

  • Corn, including popcorn
  • Dairy products – if lactose intolerant- consider supplementing with lactase or eliminating
  • Foods that cause increased gas production in the gut (onions, broccoli, cabbage, beans, legumes, lentils, etc.)
  • High fiber foods (chia seeds, avocado, pasta, chickpeas, quinoa, oats, almonds etc.)
  • Fried foods
  • Nuts and seeds, including peanut butter
  • Some raw fruits
  • Coffee and tea
  • Chocolate
  • Fats (butter, mayonnaise, cooking oils)
  • Alcoholic beverages
  • Red meat
  • Pork
  • Spicy foods

As you can see, there are many foods on this list, and others may also cause irritation and flare-ups.  This is why a food journal is essential.  It is worth the effort!

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Another strategy is to try an elimination diet.  The way this works is you start by eliminating many foods and if your symptoms improve, you begin to add foods back one at a time.  This can help identify which foods should be avoided in the future. 

There are several elimination diets available today.  The Whole30 is a diet my family and I tried last October.  I have written about this in a separate post if you are interested in the specifics.  I highly recommend trying it.

I was also able to locate a specific diet and cookbook on Amazon written by Patty Catsos, MS, RD, LD.  I have not tried this diet yet, and don’t suffer from IBS, but this book has great reviews.  I do not have any association with this product but will list the link below for your convenience.

https://www.amazon.com/IBS-Elimination-Diet-Cookbook-Low-FODMAP/dp/0451497724

FODMAPs

Fermentable oligo-, di-, mono-saccharides and polyols (FODMAPs) are short-chained carbohydrates.  These make their way to the end of the intestinal tract where large amounts of bacteria reside.  The bacteria break these substances down causing the release of gas which may lead to digestive issues in some individuals.  These FODMAPs also draw liquid into the intestines which can lead to diarrhea.  Most individuals with IBS are sensitive to FODMAPs and these substances can lead the flare-ups.  Examples of FODMAPs include:

Lactose – Milk sugar contained in dairy products.

Galactans – Legumes have large quantities of these.

Fructose – This is the sugar contained in fruits and vegetables.  You also find this in many packaged products.

Fructans – These are found in many grains including wheat, spelt, barley and rye.

Polyols – These are sugar alcohols and are also used in processed foods as a sweetener.  Examples include sorbitol, mannitol, xylitol and maltitol.

These substances are resistant to digestion and are passed through the intestinal tract unchanged.  FODMAPs cause an increased hydrogen concentration in the intestines of those with IBS.  They also influence the quantity of methane gas and may cause gastrointestinal symptoms in IBS patients.2

Curcumin for IBS

One of the most effective and popular herbal medicines available is turmeric.  This herb contains curcumin which has many beneficial properties.  Curcumin is known to have a wide range of effects on the gastrointestinal system.  This substance has been shown to inhibit the growth of H. pylori in both mice and on agar plates.3

Curcumin is thought to kill bacteria by inhibiting cell division.4

A study by Niamsa and Sittiwet in 2009, demonstrated the antimicrobial activity of curcumin several commonly encountered pathogenic Gram-negative and Gram-positive bacteria.5

Curcumin has also been shown to regulate the gut microbiota.  This is important because inflammatory bowel disease is partially defined by an altered, pathogenic microbiome.6

 

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One of the changes that occur in the gut is the increase in adherent invasive E. Coli (AIEC) which can promote gut inflammation.9

 

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Curcumin has also been shown to inhibit signaling that initiates the inflammatory process in the intestinal tract.11

A study published in 2006 found the addition of curcumin, 1 gram after breakfast and 1 gram after dinner, plus sulfasalazine or mesalamine was more effective than placebo combined with one of these two medications.  The mesalamine group had a 4.65% relapse rate (2/43), whereas the placebo group had a relapse rate of 20.51% (8/39).  A six month follow-up found eight more patients relapsed in the curcumin group and six additional patients relapsed in the placebo group.12

For additional information on curcumin, please refer to my blog post on turmeric below.

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Turmeric Health Benefits

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Plantago Ovata

Plantago ovata, also known as Desert Indian wheat or psyllim husk has been used as a medicinal plant.  Psyllium is often used as a bulk forming laxative to support normal bowel movements.  Psyllium is marketed as Metamucil.   We also have this product available in capsule form in the Sunshine Store.  There have been studies showing psyllium to be useful in the treatment of UC.13

Probiotics in Inflammatory Bowel Disease

Probiotics would seem to be helpful in IBD.  Ingesting “good” bacterial should fend off some of the “bad” gas-producing bacteria.  At the present time, the studies show that probiotic supplementation is a promising adjuvant treatment in ulcerative colitis.  It is best to use a combination Probiotic such as Probiotic-40 available below.   There is not enough clinical evidence to support the use of probiotics for Crohn’s disease at the present time.14

Probiotic-40

Contains four different probiotic strains
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Inflammatory bowel disease can be a debilitating illness and may be dangerous in some cases.  This condition may lead to a decrease in the absorption of critical nutrients and can also lead to bleeding and/or intestinal obstructions.  I suggest visiting your physician on a regular basis, keeping a food journal, and consider adding nutritional supplements to your medication regimen.  Your physician can tell you if you are deficient in vitamin B-12 or other necessary vitamins or minerals.  I strongly recommend a turmeric supplement.  This is one of the healthiest natural herbs available today.  Psyllium may also be beneficial but caution should be observed as large fiber loads can increase IBS symptoms in some individuals.  Be sure to check with your physician before starting this or any other supplement. 

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Michael J. Brown, RPh, BCPS, BCPP

Mr. Brown is a Clinical Pharmacist specializing in pharmacotherapy and psychiatry.

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Feel free to send Michael a message using this link.

 
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L-Arginine and Cardiovascular Disease, IVF, PCOS, and More..

Posted on by Michael Brown

What is L-Arginine

L-Arginine is an amino acid made naturally by our bodies and is used in protein biosynthesis.  It is also found in foods such as fish, poultry, red meat, and dairy products. L-Arginine is vital to overall health.  It is associated with the Krebs Cycle and is a part of the urea cycle where it carries nitrogenous waste.   This amino acid also causes vasodilation by its conversion to nitric oxide (NO).1

It is important in maintaining the acid-base balance of the body as the urea cycle is a significant consumer of bicarbonate.

We have recently added this supplement to our product line mostly to be used by athletes.  I will cover this, as well as some uses of L-Arginine in this post. 

L-Arginine and in vitro fertilization (IVF)

In vitro fertilization has become increasingly popular for couples who struggle to become pregnant.  This is often attempted during the later child-bearing years after the woman has failed to become pregnant.  There is some research to suggest L-Arginine can increase the number of oocytes collected in women attempting IVF.  This, however, has yet to be shown to improve the viable pregnancy rate.2

L-Arginine and Polycystic Ovary Syndrome (PCOS)

A small study of eight patients with polycystic ovary syndrome was published in December of 2009.  This study showed that a combination of L-arginine 1600 mg daily combined with N-acetylcysteine 1200 mg daily for a period of six months resulted in moderate improvement of menstrual function and decreased insulin resistance.3

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L-Theanine Effects on Cardiovascular Disease and Exercise

L-Arginine may lessen angina symptoms and improve exercise and quality of life in angina patients according to a study published in 2002.4

Another randomized, double-blind cross-over study published in September of 2000, found that, although L-arginine supplementation did not affect exercise-induced changes in QT interval, QT dispersion, or the magnitude of ST segment depression, it significantly improved exercise tolerance.  This is most likely the result of improved peripheral vasomotion.5

Many studies have found L-arginine to be effective and decreasing both systolic and diastolic blood pressure.  This has been shown in healthy individuals, those with pulmonary hypertension, as well as patients with type 2 diabetes.6

 

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L-arginine also appears to have an additive vasodilation effect when combined with angiotensin converting enzyme (ACE) inhibitors and nitrate vasodilators when used for the treatment of hypertension.10

 

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Intermittent claudication associated with peripheral arterial disease symptoms have also been shown to improve with the administration of oral or intravenous L-arginine for short term periods (up to eight weeks). 15

 

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Although this is promising, walking speed, walking distance, or absolute claudication distance does not seem to improve with long-term (up to six months) administration of L-arginine. 18

 

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L-Arginine and Erectile Dysfunction (ED)

L-arginine has shown some promise in the treatment of erectile dysfunction.  A double-blind, placebo-controlled study of 50 men with organic ED showed significant improvement in sexual function in 9/29 (31%) of the treatment group but only 2/17 (11.8%) of the placebo group.  The nine patients in the treatment group that showed improvement all had initially low NOx but this level doubled by the end of the study.20

L-arginine seems to be effective in men with mixed-type impotence when combined with Pycogenol at 1.7 grams daily or when combined with both Pycogenol and aspartic acid when dosed at 0.69 grams daily.21

 

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L-Arginine and Statins

The combination of L-arginine and atorvastatin (Lipitor) has been shown to have a significant positive effect on the progression of atherosclerosis.  A study utilizing rabbits found this combination to achieve a 21% decrease in the total area of lesions and a 44% reduction in the area of abdominal lesions compared to the control group.23

A two-arm, randomized, double-blind study on 33 hypertriglyceridemic patients reported that L-arginine alone had no effect on serum lipids compared to placebo. When combined with simvastatin, however, led to a significantly larger reduction in triglycerides compared to placebo plus simvastatin.  This study also found L-arginine attenuated simvastatin-induced increases in aspartate transaminase and fibrinogen.24

L-Arginine and Body Building

L-arginine is popular with body builders because it helps in the synthesis of proteins.  As muscle mass increases, L-arginine helps signal muscle cells and encourages growth hormone release and the metabolism of fat.  This leads to a more defined, stronger, well-defined physique.  L-arginine can also improve endurance and muscle conditioning due to its vasodilation effects.  This increases blood flow to muscle during workout periods.

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L-Arginine Drug Interactions

ACE inhibitors, Angiotensin Receptor Blockers (ARBs) and other antihypertensive agents – The combination of L-arginine and ACE inhibitors may lead to increased vasodilation and a larger decrease in blood pressure.  When combined, the risk of hypotension exists. Examples include benazepril, captopril, Ramipril, losartan, valsartan, diltiazem, amlodipine, and many more.

Anticoagulants and Antiplatelet Drugs – L-arginine may decrease platelet aggregation in humans.  Caution should be exercised when combining L-arginine with medications that increase bleeding risk.  Some examples are warfarin, apixaban, rivaroxaban, enoxaparin, clopidigrel, ticlodipine and others.

Isoproterenol and Nitrates – L-arginine may lead to increased vasodilation when combined with vasodilators leading to hypotension and dizziness.

Sildenafil (Viagra) – Although not reported in humans, combining L-Arginine with sildenafil may lead to increased vasodilation and dizziness as well.

Potassium-sparing diuretics – There have been some reports of L-arginine causing hyperkalemia in some patients.  Combining L-arginine with these medications may increase the risk of hyperkalemia.  Examples of these medications include amiloride, spironolactone, and triamterene.

Adverse Effects of L-Arginine

L-Arginine is generally well tolerated.  The most common side effects reported for this supplement are:

  • Abdominal pain
  • Bloating
  • Diarrhea
  • Nausea
  • Gout
  • Allergic reactions
  • Exacerbation of airway inflammation in asthmatic patients

L-arginine is an amino acid which helps in the synthesis of proteins.  It also leads to vasodilation and, in doing so, can be beneficial for relieving chest pain.  When combined with a statin, L-arginine leads to a decrease in atherosclerosis which may help prevent heart attacks.  It has also been shown to decrease both systolic and diastolic blood pressures.  Due to its vasodilation properties, L-arginine may help with the symptoms of erectile dysfunction. It may also help with some of the symptoms of polycystic ovary syndrome when combined with N-acetylcysteine.

We recently added L-arginine as a dietary supplement to our product line with the thought of making it available to body builders.  It can increase exercise tolerance and help create a sculpted, muscular body.  As it turns out, many other uses are possible with this substance. 

L-arginine is relatively safe and well tolerated as it is an amino acid found in the human body.  As with any other medication or supplement, allergic reactions are always a possibility.  These reactions are often due to fillers and other substances used to produce the dosage form rather than the active chemical.  Gastrointestinal side effects are always a possibility as well.

If you have any questions about L-arginine or any other medication or supplement, please feel free to send me an email.  I have spent over half of my life working with medications and supplements.   As I have expressed in the past, if I do not know the answer to your question, I will find it.  Have a great week and live a happy, healthy life.  Get plenty of exercise, drink adequate amounts of water, and eat whole foods.  You are worth it.

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Michael J. Brown, RPh, BCPS, BCPP

Mr. Brown is a Clinical Pharmacist specializing in pharmacotherapy and psychiatry.

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Bipolar Depression Treatment – Seroquel, Latuda, and Others

Posted on by Michael Brown

The first line medication treatments for bipolar depression are explored along with signs and symptoms of mania and depression.

Abnormal Condition of Dry or Scaly Skin in Older Individuals

Posted on by Michael Brown

What can be done to prevent dry skin as you age?

The skin is the largest organ of the body. It serves as a barrier and protects us from bacteria. 

Skin also helps to regulate body temperature and allows us to respond to heat, cold, and touch. There are three layers that compose the skin.

  • Epidermis – This is the outer layer that serves as a barrier. The epidermis keeps pathogens from entering the body and regulated water being released from the body.
  • Dermis – The layer below the epidermis is called the dermis. This layer contains blood vessels, nerve endings, sweat glands, and hair follicles.
  • Hypodermis – This layer contains fat and connective tissue, and provides cushioning and insulation to the body.

Dermatologists are specialized physicians who diagnose and treat various conditions of the skin. This post will explore dry skin, its causes, treatments, and effects on the aging population.

Effects of Age on the Skin

As we age, our skin becomes thinner. The number of blood vessels, nerve endings, and the amount of connective tissue also decrease. These changes lead to a reduced ability to retain moisture, control body temperature, and sense the environment.

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Pruritis, or itching, is the most common complaint involving the skin in older individuals. Short-term itching, less than six weeks, may protect us, but pruritis lasting more than six weeks can be bothersome. Pruritis can effect the quality of life and, in some cases, patients would rather live a shorter life without symptoms than live longer with pruritis.

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Dry skin (xerosis) is more common in older individuals and those living in colder climates. Heating homes in the winter months leads to decreased humidity that can dry the skin.

Prevention of Dry, Itchy Skin

The best treatment for most anything is prevention. 

Dry, itchy skin is no exception. 

The first step is to monitor the health of the skin regularly. This can be done by scanning the body for problem areas. A physician may also perform skin monitoring during a routine physical exam. 

Some causes of dry skin include:

  • Cold, dry air during the winter months
  • Skin damage from the sun
  • Use of soaps and detergents that damage the skin
  • Excessive immersion in water (taking long baths)
  • Some diseases such as lymphoma, malnutrition, hypothyroidism, eczema, and others
  • Direct exposure to fan heaters

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    One of the best ways to prevent dry to skin is to eat an adequate amount of protein, vitamins, and fatty acids.

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Best Foods to Eat for Healthy Skin

What should you eat to help keep your skin healthy? In general, fresh fruits and vegetables are a good choice because of the vitamins and antioxidants. Below are some great suggestions.

  1. Salmon – Fatty fish, such as salmon, contain omega-3 fatty acids which reduce inflammation and keep the skin moisturized.

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  1. Bell Peppers – Bell peppers are an excellent source of beta-carotene, especially the red and yellow variety. Green bell peppers are picked before they turn color and do not contain as much beta-carotene, which is converted to vitamin A in the body. Bell peppers are also high in vitamin C, which helps keeps the skin healthy by helping form collagen.

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3. Broccoli –

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Probably my favorite vegetable, broccoli, contains many vitamins and minerals necessary for good skin health, including:

  • Vitamin A
  • Vitamin C
  • Zinc

Broccoli, as well as cabbage, cauliflower, and kale, also contains sulforaphane. This substance may protect the skin from the sun’s damage, thus decreasing photoaging.

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  1. Avocados – Packed with healthy fats, this guacamole ingredient can improve skin health by moisturizing and improving flexibility.

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Avocados also contain vitamins C and E, which act as antioxidants. One symptom of vitamin C deficiency is dry, scaly skin. Vitamin C also is needed to make collagen that helps keep skin healthy and strong.

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  1. Tomatoes – Another favorite of mine, tomatoes contain vitamin C, lycopene, and beta-carotene. 

These substances can protect skin from the sun and help prevent wrinkles.

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  1. Soy – Isoflavones are contained in soy. These have been shown to improve skin elasticity and decrease fine wrinkles in at least one study.

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Isoflavones can also protect the skin from the sun’s harmful rays.  

  1. Sweet potatoes – We started eating more sweet potatoes when consuming the Whole30 diet. These are an excellent beta-carotene source that can protect the skin from the sun. Sweet potatoes are a better option than white or yellow potatoes. Give them a try.
  1. Green leafy vegetables – spinach, kale, and collard greens contain vitamins A, C and E. They are also a good source of protein and spinach contains selenium which can protect the skin from UV rays.
  1. Eggs – These are a good source of protein, selenium, zinc, vitamin A and vitamin C.  

10. Healthy oils –  Extra virgin olive oil and fish oil can help with keeping the skin moist and pliable.

Best Nutritional Supplements for Healthy Skin

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Dietary supplements may be necessary if you cannot get enough nutrients from the foods you eat. 

Some of these can be found in the Sunshine Store. The supplements listed below are the same as those contained in the foods above.  

  • Fish Oil
  • Vitamin A
  • Vitamin C
  • Vitamin E
  • Zinc
  • Selenium

Topical Agents for Dry Skin

Daily use of moisturizers that hydrate the skin is important. Some examples of ingredients that can help are:

 

Topical Urea – This is a molecule produced by our body that is naturally found in the skin. It is generated from the metabolism of proteins and other compounds. 

Urea is excreted in the urine and through sweating.

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Urea is one of the best moisturizing agents available to dermatologists today. It has been used safely for over a century and can be utilized for several skin conditions. Urea has different effects on the skin, depending on the concentration employed. At lower concentrations (~10% or less), it acts as a moisturizer, while at concentrations greater than 10%, it has an emollient/keratolytic action. Urea can also enhance the penetration of other molecules through the skin and is used in combination therapies.

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Other skin moisturizers available include glycerin, lactic acid, and petrolatum.

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Other Ways to Help Dry Skin

  • Avoid traditional soaps – regular soap can alkalinize the skin damaging the moisture barrier. Synthetic cleansers such as Dove, Olay, and Cetaphil are preferred.
  • Avoid excessive washing – This can worsen dry skin, especially if very hot water is used. 
  • Avoid aggressive scrubbing and use luke-warm water.
  • Use a Humidifier – Increasing humidity can help decrease skin drying, especially in the winter months.

 

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 As we age, our bodies go through many transformations. Energy levels decrease, our kidneys and liver don’t work as well, and we have a higher percentage of body fat. Our skin also changes and becomes thinner, less pliable, and dry. If we don’t care for our skin, it can crack, leading to pain and possible infection.  

 

One of the best things you can do for your body at any age is to eat fresh, whole foods. If you eat a healthy, balanced diet, you are likely to help your skin stay strong and healthy. Always stay hydrated, exercise, and use high-quality moisturizing lotions. 

 

If you live in the northern part of the country where it is cold in the winter, consider using a humidifier to help decrease the effects of dry air on your skin.  

 

Avoid excessive bathing, especially with very hot water, as this may dry your skin. Stick with high-quality synthetic cleansers, and be sure to monitor your skin for dry, scaly areas. If you find problems with your skin, see your doctor. There are medicated creams and lotions available to help relieve the various skin conditions you may be suffering from.

Skin integrity is vital to our overall health. If you have any questions regarding this topic, or any other health or fitness related subject, feel free to contact us. If you have ideas for future blog posts, let me know. My goal is to keep you entertained and informed. Have a great day; be happy, healthy, and keep smiling.

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Michael J. Brown, RPh, BCPS, BCPP

Mr. Brown is a Clinical Pharmacist specializing in pharmacotherapy and psychiatry.

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Feel free to send Michael a message using this link.

 

 
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Female Pattern Hair Loss, PCOS Alopecia Treatment, What Works?

Posted on by Michael Brown

Female pattern hair loss (FPHL), also called female androgenic alopecia is a diffuse, non-scarring loss of hair.  The hair loss is most apparent in the frontal, central, and parietal scalp regions.  This condition is most common in adult females and its incidence increases with age.  Unfortunately, this disease shows variable responses to treatment.

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Not surprisingly, FPHL can lead to low self-esteem, poor body image, depression, and a lower over-all quality of life.

We know that the hair follicle changes in alopecia are similar for men and women, but the presentation and response to therapy is different. 

FPHL normally occurs during the reproductive years.  The second peak occurs at menopause (50-60 years of age).  A study conducted in 2001 found a 3% incidence of FPHL among 1008 Caucasian women in their 30’s.  This prevalence increased slowly with age and was 32% in the ninth decade of life.  The combined prevalence was 19%.

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Minoxidil

The first line of treatment for FPHL is Minoxidil (Rogaine).  Many are familiar with Rogaine as it has been approved for use in men’s hair-loss since 2006.

We are not completely sure how minoxidil works but it is thought to promote the growth phase of the hair follicle, shorten the resting phase, and enlarge miniaturized follicles.

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 In 2014, 5% minoxidil was approved for FPHL.  Before this, only 2% minoxidil solution was approved for use in women.  Studies have shown that once daily application of a 5% foam is as effective as twice daily application of a 2% solution.  This is important because once daily application is more convenient for the patient. 

There are side effects associated with the use of minoxidil.  During the Rogaine clinical trials conducted by Johnson and Johnson, the following side effects were reported in at least 2% of the study participants.

  • Weight Gain
  • Headache
  • Itching
  • Nasal and upper respiratory tract infections        4

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One of the common concerns among women using hair growth products is the worry of hair growing in the wrong places.  Hypertrichosis has been reported with both strengths of minoxidil but is significantly less with the 5% foam.

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It is recommended that minoxidil be applied at least 2-4 hours prior to bedtime with hands thoroughly washed after application to limit unwanted hair growth on the face.

Although I do own stock in Johnson and Johnson, I currently am not paid for promoting their products.  I have included the link to the Rogaine site below as a convenience to my readers.  Both 2% solution and 5% unscented foam are available at:

https://www.rogaine.com/products/womens-hair-regrowth-solutions#women

Other Treatment Options

If Minoxidil is ineffective, other medications may be tried.  It is important to note that although these secondary treatments may be tried, no conclusive evidence supporting their effectiveness is available.  In fact, a Cochrane Review including 47 trials with 5290 subjects, found only minoxidil to be effective for FPHL.

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Although evidence is lacking, these systemic treatments are still utilized in some situations.  They will be briefly discussed here.

Spironolactone

Spironolactone is an aldosterone antagonist.  It works by blocking androgen receptors and has some inhibition of androgen synthesis.

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It is usually the initial second-line agent employed for FPHL because it is often used in women for other indications such as acne, hirsutism, and polycystic ovarian syndrome.  This gives providers more confidence in regards to side effects and tolerability.  Spironolactone has limited positive data available for its use in FPHL.  One open-label study treated patients with either spironolactone or cyproterone.  The average duration of treatment in this study was 16 months.  There was not difference between the groups.  Forty-four percent of the patients experienced regrowth of hair, forty-four percent showed no change, and twelve percent had continued hair loss.

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Finasteride

Finasteride is often used to treat baldness in men.  It works by inhibiting the conversion of testosterone to dihydrotestosterone.  This medication is usually well tolerated in females and because of the limited options for women who fail minoxidil, it may be another option.

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Flutamide

Flutamide has a few studies supporting its usefulness in FPHL.  In one prospective cohort study of 101 premenopausal women, flutamide was associated with an average of 15% improvement of hair thickness at six months and 28% at two years.

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Another case study found flutamide reversed hair loss in a patient who had failed treatment with a combination of spironolactone and topical minoxidil.

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Flutamide is associated with side effects such as decreased libido, GI distress and rarely liver failure.  The threat of liver failure has limited flutamide’s use in FPML.

Low-Level Laser Light Therapy (LLLT)

Photobiomodulation therapy, or low-level laser light therapy has also been used to treat FPHL.  A study published in 2014 in The American Journal of Clinical Dermatology found a clinically significant difference in terminal hair density between an FDA approved low-level laser product (Lasercomb) and a sham device.  This was a randomized, double-blind sham device controlled study of 128 male and 141 female subjects. 

The patients who used the Lasercomb also reported an improvement in hair thickness and an overall improvement of their hair loss condition as compared to the sham treated patients. 

There were no serious adverse effects reported with the use of the Lasercomb.  This device may be a good alternative for hair-loss patients who either do not respond to medications or have adverse effects or contraindications to available treatments.

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More information on the Ultima 9 Classic LaserComb can be found at:

https://hairmax.com/products/ultima-9-classic-lasercomb?variant=30328901664886&currency=USD&gclid=Cj0KCQiApt_xBRDxARIsAAMUMu_CUgG6KDzv5d4DMnuOrpiGeL5NHVb0edgODpcXETrwB8E1rGCknE8aArzhEALw_wcB

Surgery

When all other treatments fail, hair transplantation surgery is an option.  Unfortunately, this is not always effective as transplant failure is possible.  This procedure is also costly and time-consuming for the patient.  There may also be an increased amount of hair loss early on and pain and infection is also a risk.

 

PCOS Alopecia Treatment

Polycystic ovarian syndrome (PCOS) alopecia is caused by an increase in male hormones.  Treatments for this are the same as those listed above.  In addition, birth control pills may be used to help decrease androgen levels.  Oral contraceptives not only help with hair loss but also can be effective for the treatment of other PCOS symptoms such as acne and irregular menstruation.  

There is evidence that weight loss in women with PCOS can also decrease androgen levels.  Even a loss of five to ten percent of body weight can have a significant effect on PCOS symptoms.14

Female pattern hair loss is an unfortunate ailment that increases in prevalence with age.  This condition leads to poor self-esteem, a distorted body image, and may even lead to depression.  Unfortunately, the treatments available for this disorder are scarce.  The only scientifically proven method is topical minoxidil, or Rogaine.  Other treatments have been used with some success but are not well supported by the clinical literature. 

Please leave any questions or comments below.  Thanks for reading, and have a great day!

Cassie Brain Focus and ACV

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Michael J. Brown, RPh, BCPS, BCPP

Mr. Brown is a Clinical Pharmacist specializing in pharmacotherapy and psychiatry.

Read Michael’s story here.

Feel free to send Michael a message using this link.

 

 
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The 2019 Novel Coronavirus – What You Need to Know

Posted on by Michael Brown

Coronaviruses are a group of viruses that can be transmitted between animals and humans.

These viruses can cause mild ailments such as the common cold as well as more severe infections requiring hospitalization.

The latest outbreak initiated in China has already killed 427 people worldwide, as reported by NBC News on February 4th, 2020. This is alarming since this virus has only recently been identified as 2019-nCoV on January 7th, 2020.

How is this virus spread?

What can you do to protect yourself?

How Does This Virus Spread?

Since this is a new virus, we can only speculate on how it is transmitted.  It can be assumed that its spread is similar to other coronaviruses.  These viruses are normally spread by close physical contact (usually six feet or less). 

Droplet transmission is the most likely culprit. 

When an infected patient coughs or sneezes, droplets may be inhaled by others or land in their mouths or noses.  It may also be transmitted by touching a surface contaminated with these droplets and then touching the mouth, eyes, or nose, but this is not currently confirmed.

There is no vaccine against this virus at the current time.

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Coronavirus Symptoms

The symptoms of the new 2019-nCoV virus are as follows

  • Fever over 100.4 degrees
  • Muscle aches
  • Breathing problems
  • Malaise
  • Cough

Some people with this virus will show no symptoms but may still spread the virus to others.  Some patients may have severe symptoms such as pneumonia, hypoxia, and even death.

The risk of death is higher in those who are immunocompromised, prone to pneumonia, elderly or frail.

Coronavirus Treatment

There is currently no treatment for this virus other than supportive measures.  Viruses are difficult to treat with medications.  A hospital stay may be necessary to keep the patient comfortable and prevent the condition from deteriorating.  In severe cases, being treated in the ICU to support breathing may be necessary. 

The FDA has approved the use of hydroxychoroquine (Plaquenil) on 3/30/2020 for the treatment of COVID-19.  This drug helps dry secretions in the lungs.  One of the main causes of death from this virus is respiratory failure.

Prevention of Coronavirus

The best way to prevent this infection is to stay away from others who have it, wash your hands often, and clean work surfaces used by others frequently.  Since it is not possible to know who has the virus, the recommendation is to stay six feet away from everyone.  It is also mandated that people in the USA stay home unless they must shop for food or are in critical positions and must go to work.  The social distancing guidelines are in effect until April 30, 2020.

If you are not familiar with the correct hand-washing technique, please refer to:

 https://www.cdc.gov/handwashing/

  • Hand washing is extremely important for optimal health.
  • If you don’t need to travel to China, don’t. 
  • Avoid touching your eyes, nose, or mouth with unwashed hands.
  • Cough or sneeze into a tissue and promptly throw the tissue in the trash.

If you are living with someone who you think may be infected with coronavirus, do the following:

  • Stay in a separate room and use a different bathroom if possible
  • Clean all surfaces the infected person may have had contact with well!
  • Wear disposable gloves, a disposable gown, and a face mask when caring for them, be sure to wash your hands thoroughly after providing care.
  • Have the infected person wear a mask if possible. If this causes breathing problems, others in the same room as the patient should wear a mask.
  • Keep all surfaces very clean, especially ones the patient comes into contact with.

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What if I Get Infected?

If you believe you have contracted this virus, see your doctor.  This is especially important if you have a high fever or trouble breathing.  Do not go to highly populated areas as this may cause the disease to spread.  Stay home from work.  If you are severely ill, go straight to the emergency room. 

The hospital or doctor will test you to confirm you are infected with 2019-nCoV.

It is important to stay away from elderly patients, those who are immuno-compromised, small children and anyone who is susceptible to pneumonia if you suspect you may have this virus. 

Protecting yourself against the coronavirus is much the same as avoiding other illnesses.

Stay away from other infected individuals.

Wash your hands often.

Do not travel to destinations where the disease is prevalent.

Wear protective clothing (masks, gowns, gloves) when caring for others with the condition, and keep yourself in good physical condition.

This virus is more dangerous in those with pre-existing respiratory problems, those who are immunocompromised, and the elderly and frail.

If you have any questions, feel free to contact me.

UPDATE

 As of 03/30/2020, there have been over 143,000 deaths attributed to this virus in the USA.  This has turned out to be much worse than originally thought.  The best resource I have been able to find for updated information can be found at the link below.

https://coronavirus.jhu.edu/

Stay safe, and always remember to be happy and healthy.  Please follow the guidelines issued by the government regarding this virus.  Many lives depend on it!

Michael Brown in Lab Coat with arms crossed

Michael J. Brown, RPh, BCPS, BCPP

Mr. Brown is a Clinical Pharmacist specializing in pharmacotherapy and psychiatry.

Read Michael’s story here.

Feel free to send Michael a message using this link.

 

 
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Snoezelen Therapy for Dementia Patients

Posted on by custom
Woman in sensory room holding fiber optics

Disclosure:  This post may contain affiliate links, meaning, at no additional cost to you, I may earn a commission if you click on, or make a purchase through a third-party link.

The world population is ageing and, because of this, the incidence of dementia has risen.  According to the World Health Organization, approximately 50 million people have dementia worldwide, and 10 million new cases are diagnosed every year.  The incidence of dementia is expected to reach 131 million people by 2050.1

  Dementia has a tremendous impact on both the patient, and the family.    Patients with dementia are unable to remember things, have a difficult time solving problems, and can become easily frustrated.  Their sleep-wake cycle may become reversed and, at times, they may even become violent to the ones they love.  Dementia occurs in older people but is not a normal part of the ageing process.

Dementia patients may reach a point where they need to be hospitalized due to behaviors which are not able to be controlled by their caregivers.  Some of these behaviors include agitation, depression, aggression, and apathy.

I have been working on a unit which cares for dementia patients for three years.  During this time, I have learned a great deal about this condition as well as common and not so common treatments.  I have written other blog posts relating to dementia but this post will concentrate on the use of Snoezelen therapy for these patients.

A Snoezelen room is a controlled multisensory environment (MSE).  Equipment in these rooms cause a variety of stimulation including tactile, auditory, olfactory and visual.  Snoezelen rooms should provide a calm and comfortable environment for the patients.  These rooms can be used for patients with autism, brain injuries, developmental disabilities as well as dementia.  MSE’s are not inexpensive to set up.  Associated costs could run from $10,000 to $30,000 and even more if complex, high-end equipment is used.

2

Assessing Unmet Needs

The Unmet Needs Model suggests negative behaviors in dementia may result from the inability to communicate one’s needs to caregivers.  There are ways in which we can attempt to learn what these unmet needs are by trial and error.  In the hospital setting, we often talk about the following possibilities that may make the patient uncomfortable.

  • Pain – This one is difficult to assess. There are pain signs such as grimacing.  The patient may also be suffering from a urinary tract infection, or other ailment.
  • Constipation – Keep track of bowel movements. Constipation can be uncomfortable, and is usually easy to treat.
  • Hunger – Offer food. Attempt to learn the patient’s food preferences by speaking to those close to the patient.
  • Thirst – Offer fluids.
  • General Comfort – How the patient is sitting, temperature, clothing, etc.

If these don’t help, the patient may be suffering from boredom.  This is where the Snoezelen room can help.  Always remember, dementia patients are people like us who have a disease and it is important to view them as such.  What works for one patient, may not be effective for another.  Get to know what the patient prefers and keep track of successful interventions.  Always start with the basic needs described above.  If the patient is in pain or uncomfortable due to being constipated, a Snoezelen room experience will likely have little effect on behavior.

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Benefits of Multisensory Environments in Dementia Care

Later stage dementia patients are usually unable to seek out enriching and meaningful activities on their own.  In fact, left to their own devises, they would quickly decline.  Most of the time, they are completely dependent on others for their care.  Older people are also less able to perceive sights, sounds, tastes, and smells which increases their risk of sensory deprivation.3

This can have a negative impact on health and wellbeing.4

Some believe that sensory experiences are able to trigger positive memories.  This may promote a feeling of pleasure for the patient.  Think about this in your own life.  I believe we’ve all experienced being taken back in time when we’ve smelled something that triggers a positive time in our lives, or heard a song that takes us back to a happy time.5

6

The goal of the multisensory environment is to positively effect the dementia patient using sensory channels that are still intact. 

The three main avenues by which a multisensory experience can be achieved are.

  1. Daily care routines such as bathing, feeding, and administering medications 7

    8

  1. Sensory enhancements of the patients living environment. This may include special units in long-term care facilities which provide staff specially trained to care for dementia patients, special activities geared towards these residents and involvement of the family.9

  1. Specially designed rooms or MSEs.10

Studies have shown that MSEs can be beneficial for dementia patients.  Some of these benefits include.

  1. Decreased agitation and disruptive behavior.

    11

     

    12

     

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I would like to point out that some of the medications utilized to combat aggressive and disruptive behavior can cause agitation.  

  1. Increased alertness14

  1. Increased social interaction, reduced apathy, and better mood.15

    16

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  1. Better communication with others.18

  1. Improved functional performance19

These positive attributes of MSEs leads to a more relaxed, engaged patient who gets along better with his or her peers. 

Research also shows caregivers who utilize MSEs for their dementia patients have better job satisfaction and a better relationship with their patients.

20

This leads to improved patient care and reduced caregiver burnout.

Obstacles to Adding a Snoezelen Room to a Facility

Many facilities do not have the financial resources or space to implement a Snoezelen room.  As mentioned earlier in the post, these spaces can get expensive.  The institutions who have these rooms often under-utilize them.  Another problem is deciding how to design such a space.  There is much debate on exactly what to put into these rooms and research is still being conducted in this area. 

Anti-suicide regulations can also hinder certain facilities from adding a Snoezelen room.  This is especially true of psychiatric facilities where dementia patients may end up due to negative behaviors.

Perspectives of an Expert

I have the pleasure of sharing an office with an occupational therapist.  Kendra Munroe, OTR/L works with our patients daily and was the person who designed our sensory room.  Our main piece of equipment is a Vecta which was purchased from TFH Special needs Toys.  This company specializes in sensory-focused equipment and toys which promote learning and living skills.

The Vecta Full Mobile Sensory Station can turn any room into a relaxing, distracting and empowering multi-sensory room. 

According to Kendra, the sensory room “provides a safe and contained spot where the patients can explore”.  She explains that you want to have different things available to engage their senses.  Some examples include music that is tailored to the specific patients tastes, as well as things they can see or touch.  Kendra also believes it is important to include things related to nature. 

We provide weighted blankets by Salt of the Earth as well as quilts, stuffed animals, robotic pets, and a weighted baby doll to provide a realistic sensory experience.

Munroe stated that certain things are often neglected in sensory rooms, specifically regarding the geriatric population.  She mentioned things that provide proprioceptive and vestibular input in particular. “This is why we put a glider in,” Kendra explains.  We purchased a specific glider that locks in place when the patient attempts to stand.  The Thera-Glide safety glider decreases fall-risk and rocks back and forth which is soothing to the patient.

Kendra does point out that there may be dangers involved with sensory rooms.  She emphasizes that we must be trauma-informed with any of our treatment.  We must be aware that small, enclosed spaces may bother some patients.  We also need to be sure there are no objects or equipment available that the patient may throw due to confusion. 

Dementia patients should never be left alone in a sensory room.  They may become confused because the room is unfamiliar to them.  They may damage the equipment, or injure themselves.

Munroe ended by saying that we really didn’t have many guidelines available to us when setting up our sensory room.  We tried to provide a mixture of adult and pediatric sensory experiences that we believed would be most beneficial to our patient population.

Michael Brown pictured with Final Thought written

I am a big supporter of sensory rooms.  My thought is we should utilize all other treatment modalities prior to resorting to medications for dementia patients.  All drugs come with side effects and currently there are no medications indicated for the behavioral and psychological symptoms of dementia. 

Always try to meet the basic needs of the patient before moving on to other therapies.  Assess for pain, hunger, thirst, constipation and comfort. 

As a society, we have a responsibility to care for our ailing population.  This includes the mentally ill.  Unfortunately, none of us are immune from this debilitation condition.  We can all learn about it, and try to limit our risk of developing dementia.  I will continue to write about this subject as I believe it is very important.

If you have any questions regarding Snoezelen rooms or dementia in general please reach out to me.  I have access to some of the best professionals in this area. 

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Michael Brown in Lab Coat with arms crossed

Michael J. Brown, RPh, BCPS, BCPP

Mr. Brown is a Clinical Pharmacist specializing in pharmacotherapy and psychiatry.

Read Michael’s story here.

Feel free to send Michael a message using this link.

 

 
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Probiotics Gut-Brain Axis and Psychiatry

Posted on by sunshineneutraceuticals

Disclosure:  This post may contain affiliate links, meaning, at no additional cost to you, I may earn a commission if you click on, or make a purchase through a third-party link.

Is it possible to treat mental health disorders by altering bacteria in the gut?

 

What is the Gut-Brain Axis?

 

Can the drugs we use to treat psychiatric disorders make patients worse by altering the bacteria living in the gut?

 

There have been many articles and studies published recently discussing the possible connection between the microflora of the gut and the progression of neuropsychiatric disorders. The bacteria in the gut are affected by many factors, including age, diet, exercise, health, and genetics. Medications can also alter gut bacteria. This post will explore the possible effects of the gut microbiome on various psychiatric disorders. 

 

The Gut-Brain Axis

The Gut-Brain Axis is a network of nerves, hormones, and immunological factors connecting the central nervous system (CNS) to the Gastrointestinal (GI) tract. It appears that the gut flora are involved in this system. An imbalance in the function and composition of these intestinal bacteria is associated with many disease states. 1

The microbes in the gut contain genes that perform metabolic functions. The metabolites resulting from these reactions can produce local effects in the GI environment or gut wall. These microbial metabolites may also be absorbed into the systemic circulation and exert their effects on other organs, including the brain.

It is now known that there is bidirectional communication between the gut and the brain. This communication network is known as the gut-brain axis. 2

Altered microflora of the gut has been associated with depression, other mood disorders, and neurodegenerative diseases. 3

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It is known that patients with GI diseases often suffer from mental health issues. 6

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We also know that approximately one-third of patients with irritable bowel syndrome (IBS) have depression. 10

In patients with functional gastrointestinal disorders (FGIDs), 36.5% have comorbid psychiatric disorders. The most common of these are general anxiety disorder and panic. 11

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Effects of Medications on Gut Bacteria

Psychiatric medications are known to disrupt the microbiome of the gut. 12

Second-generation antipsychotics, such as olanzapine, change the balance of intestinal bacteria leading to obesity.

Antidepressants such as selective serotonin reuptake inhibitors (SSRIs) may inhibit Staphylococcus and Enterococcus growth. 13

 

14

 

15

The Belgian Flemish Gut Flora Project found both benzodiazepines and antidepressants affected microbiology. 16

The classes of non-antibiotic drugs that have the highest antimicrobial activity are antidepressants, antipsychotics, and benzodiazepines. 17

 

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The drugs we use to treat these psychiatric disorders may be making the conditions worse by altering the composition of the gut flora.

It may be possible to treat psychiatric disorders with living microorganisms. The goal would be to re-establish the healthy flora in the gut resulting in an improved gut-brain axis relationship. This is a difficult subject to study because once ingested; the living organisms are subjected to many negative environmental factors, including digestive enzymes, competitive microorganisms, and pH changes. Despite this difficulty, studies have been done, resulting in positive outcomes. 

Gut-Brain Axis and Autism Spectrum Disorders

Autism spectrum disorders are developmental disorders that affect communication and behavior. This is known as a spectrum disorder because there is a wide variety of symptoms involved. Patients with autism have a difficult time communicating, may not respond to their name, and often do not find enjoyment in activities others enjoy. They may also display repetitive, stereotyped behaviors.

The exact cause of autism is not known, but children with ASD often suffer from GI symptoms that correlate with the severity of their disorder. Several studies have reported altered gut bacteria in patients with autism.    

A treatment protocol using a fecal transplant was administered to 18 children with ASD (ages 7–16 years). The protocol started with two weeks of antibiotics, followed by a bowel cleanse. The children were then given an extended fecal microbiota transplant (FMT) using a high initial dose followed by daily maintenance doses for 7-8 weeks. 

At the end of treatment, there was an 80% reduction of GI symptoms, as measured by the Gastrointestinal Symptom Rating Scale. This included a significant decrease in abdominal pain, indigestion, diarrhea, and constipation. These improvements were still evident eight weeks after treatment. The behavioral symptoms also improved significantly and also remained eight weeks post-treatment. This procedure seemed to be effective for both ASD symptoms as well as GI symptoms and continued long after treatment was completed. 21

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Gut-Brain Axis and Bipolar Disorder

One study showed that patients with bipolar mania were twice as likely to have taken a recent course of antibiotics. 22

It has been suggested that treating bipolar patients with probiotics could help reduce hospitalizations. A small study found treating acutely manic patients with probiotics led to a decrease in the readmission rate. Dr. Faith Dickerson randomized 66 patients to receive a probiotic capsule or placebo for six months after hospitalization for mania. The probiotic, or placebo, were given in addition to the regular medication regimens. Of these 66 patients, 24 or 73% required rehospitalization, while only eight (24%) of the probiotic group was hospitalized. The probiotic patients who were admitted also had a shorter hospital stay than those treated with a placebo.

The probiotics used in this study were Bifidobacterium lactis (bb-12), and Lactobacillus rhamnosus (LGG). These strains are also found in breast milk. 23 

 

 

Gut-Brain Axis and Major Depressive Disorder (MDD)

It has been shown that mice raised in a sterile environment (germ-free mice) have an exaggerated response to stress. This can be reversed by inoculating these mice with feces in their early development. 24

 

This suggests that gut microbial stimulation helps to shape healthy brain development during the early stages of life. 25

 

A review published in 2017 in the Annals of General Psychiatry concluded that treatment with probiotics might improve MDD symptoms. The mechanism is likely a combination of serotonin availability as well as decreased inflammation. More comprehensive studies need to be completed to determine the utility of such a treatment in depression. At the present time, there is likely no harm in supplementing antidepressant medications with probiotics. 26

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Psychobiotics

Psychobiotics are substances that alter the bacteria of the gut. These may be live bacteria (probiotics) or prebiotics. Prebiotics are compounds that change bacterial composition or activity when fermented in the digestive tract. 27

In a study of 55 healthy volunteers, subjects received either fermented milk containing Lactobacillus casei Shirota, or a placebo for three weeks. The study subjects falling into the bottom third of mood scores showed significant improvement as compared to the placebo group. There were no overall changes in mood in this study, which may suggest Lactobacillus has a ceiling effect. In other words, people who are already relatively happy may not have an increase in mood after ingesting the probiotic. 28

It is important to note that not all studies have shown benefits regarding probiotics. A recent review found little evidence of positive outcomes from these substances. 29

 

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Michael Brown pictured with Final Thought written

The Gut-Brain Axis is a fascinating topic that deserves much more research. I believe we can all benefit from eating a healthy diet, exercise, and possibly probiotic supplementation.

The evidence suggests that gut bacteria are vital in helping to develop the brain at a very early stage of human development. It is also evident that many of the medications we use to treat mood disorders such as depression, anxiety, and bipolar disorder, have an effect on the microbiome of the gut.

In the future, we may be able to either successfully treat these disorders with specific bacterial agents, or supplement the healthy flora destroyed by the medications we employ to treat these maladies.

I do know that I benefitted from eating a whole food diet during my Whole30 experience. My mood improved; I slept better and was more alert and happier in general. I can’t be sure this has anything to do with the microbiome in my gut, but it is certainly possible. I hope you have learned something from this post. If you have any questions, please feel free to reach out to me.

 

In the next post, I plan to write about happiness. This is something I have been looking forward to. I want to share my secrets for staying happy and improving your mood. I think you will all enjoy it.

 

Have a great day, and stay healthy!

 

 

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Michael Brown in Lab Coat with arms crossed

Michael J. Brown, RPh, BCPS, BCPP

Mr. Brown is a Clinical Pharmacist specializing in pharmacotherapy and psychiatry.

Read Michael’s story here.

Feel free to send Michael a message using this link.

 

 
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Ethanolism – Why You Shouldn’t Drink Alcohol

Posted on by sunshineneutraceuticals

I enjoy a few drinks with friends.

I deserve a drink to calm down after a hard day at work.

Everybody drinks, right?

Disclosure:  This post may contain affiliate links, meaning, at no additional cost to you, I may earn a commission if you click on, or make a purchase through a third-party link.

I started Sunshine Nutraceuticals in July of 2019. My goal has always been to help my readers live a happy, healthy, healing lifestyle.

I know a lot, if not most, of my readers, drink alcohol.

Ethanolism – Why You Shouldn’t Drink Alcohol is not about judgment. It is not about right or wrong. This post is meant to give my readers the facts about alcohol. The first fact, and likely the most important is this:

Ethanol is a neurotoxin

 What this means is when you drink alcohol, you are consuming poison.

Is it worth it?

Like most of you reading this, I used to drink alcohol. When my second youngest child was born, I decided to stop. Not because I had to, but because I wanted to be more productive and was sick and tired of wasting money on alcohol. I wanted my kids to grow up in a home without alcohol.

My life today without ethanol is much better. I am in good shape, I think more clearly, my anxiety level has decreased, and I am saving money. 

I have seen hundreds of patients admitted to the hospital because of alcohol intoxication. The nurses in ICU will tell you these are some of the most challenging patients to manage. Alcohol withdrawal is no joke. It can kill you!

I have watched people die of liver failure due to ethanol. This is not a good way to go. Remember, your liver is the primary organ responsible for removing toxins from your body. Imagine living your final days with a body full of byproducts. We have dialysis to help with kidney disease, but if your liver fails, there isn’t much that can be done.

If you want to be healthy, ethanol will not help you achieve the goal.   

Sobering Statistics

It is estimated that 88,000 people die from alcohol-related causes each year.  1

This ranks third as the most preventable cause of death in the United States behind tobacco,  poor diet and physical inactivity. 2

In 2014, thirty-one percent of all driving fatalities (9,967 deaths), were attributed to alcohol impairment. 3

In 2017, 26.4 percent of people over eighteen years of age reported binge drinking and 6.7 percent reported heavy alcohol use in the past month:

Binge drinking: a pattern of drinking that brings blood alcohol concentration (BAC) levels to 0.08 g/dL. This typically occurs after 4 drinks for women and 5 drinks for men—in about 2 hours. 4

Heavy alcohol use: Binge drinking on 5 or more days in the past month.

Alcohol Use Disorder (AUD) in the United States: According to the 2017 National Survey on Drug Use and Health (NSDUH), 14.1 million adults ages 18 years and older have AUD. 5

Alcohol Use Disorder (AUD): AUD is a chronic relapsing brain disease characterized by an impaired ability to stop or control alcohol use despite adverse social, occupational, or health consequences. AUD can range from mild to severe, and recovery is possible regardless of severity. The fourth edition of the Diagnostic and Statistical Manual (DSM–IV), published by the American Psychiatric Association, described two distinct disorders—alcohol abuse and alcohol dependence—with specific criteria for each. The fifth edition, DSM–5, integrates the two DSM–IV disorders, alcohol abuse and alcohol dependence, into a single disorder called alcohol use disorder, or AUD, with mild, moderate, and severe subclassifications. 6

Over ten percent of children in the United States live with a parent with alcohol problems, according to a study published in 2012. 7

Drinking alcohol increases the risk of contracting the following types of cancers:

  • Mouth
  • Esophageal
  • Pharynx
  • Larynx
  • Liver
  • Breast 

8

Why Do People Drink Ethanol?

We will now explore the reasons people drink alcohol. Again, no judgment here. I am merely pointing out why you might drink.

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Alcohol Gives Me Confidence and Helps With Socialization at Parties.

What alcohol does is dull your sense of apprehension along with other mental capabilities. Our bodies have a method to combat fear, known as the “fight or flight” response. This is the body’s way of protecting us from dangerous situations. Alcohol has a depressant effect on the brain and suppresses this response.

When our “fight or flight” system is diminished or absent, it makes us vulnerable to dangerous situations. If there is a danger, we are less likely to notice and certainly not as able to respond to it. What do we call people who are drunk? Hammered, wasted, tanked, tipsy, plastered. These words describe someone who can quickly be taken advantage of or hurt. This world is full of individuals that can’t wait to take advantage of someone in a vulnerable state. 

As far as confidence goes, I would much rather spend time with a shy person than someone who is drunk and talks nonstop. Drinking to gain confidence can easily backfire, turning the person into a fool. You are much more likely to develop strong friendships if you appear as you are rather than who you are when drunk. 

Intoxicated people also have diminished impulse control. I explain this to my students in the following way:

Suppose someone has just made you very angry. You don’t like this person and think about punching them in the face. 

Most of us would not punch them. We know there are consequences to such actions. This is an example of impulse control. We stop ourselves from doing something that will undoubtedly have negative consequences. Alcohol removes some of this control. Remember, alcohol deadens all senses, good and bad. 

Why do you suppose there are so many fights in bars? 

Alcohol does not give you any special powers, and it takes away your body’s inherent protective mechanisms.

Another thing to consider is the fact that you have to get home from that party! 

Do you have a designated driver? 

How many times have you driven when you have had too many drinks?

I don’t have to tell you what happens if you get pulled over by the police on the way home.

The least you will lose is a night of freedom and a big pile of money. You could also lose your job or even your career in some cases.

Is it really worth it?

Drinking Alcohol Relaxes Me, and I Deserve That After a Rough Day at Work!

Does alcohol relax us? 

What is it doing? 

The truth is alcohol doesn’t remove stress at all. It merely enables us to ignore our body’s innate warning system. If we are genuinely “stressed,” maybe we are trying to accomplish too much. Our body is telling us to slow down.

In fact, alcohol is very good at causing stress. 

What happens when the alcohol wears off? 

We feel anxious. Most of us want more. 

Wanting more causes stress that is only relieved when we continue to drink. The next drink does induce some relaxation, but this is only due to decreasing the withdrawal symptoms caused by alcohol leaving our body.

What will happen is the more you drink, the more stress you will invite into your life. Secondly, any problems you were attempting to forget will still be there when the alcohol wears off.

Finally, if you end up drinking too much to relax, your next day will likely be worse.

Alcohol helps Me Sleep

Not a chance. It might make you think you are sleeping better, but the sleep quality is reduced. 

Ethanol is a typical “over-the-counter” sleep aid. It increases the quality and quantity of NREM sleep during the first half of the night in non-alcoholics, but REM sleep is disrupted later. The REM stage is where we dream and is considered a restful period as our muscle tone is decreased. Do not use alcohol as a sleep aid! There are many other products that work much better with fewer side effects.

Sleep quality in alcoholics is even worse. During drinking periods as well as abstinence, altered sleep architecture leads to profound insomnia and daytime sleepiness. 9 

Alcohol and Dementia Risk

As a Clinical Pharmacy Specialist in Psychiatry, I see the consequences of substance abuse often. This is one of the subjects I am most interested in and will be writing about regularly — the unit where I currently practice has geriatric psychiatric patients. 

A large percentage of these have dementia. There are four basic types of dementia. Alzheimer’s disease, Lewy body dementia, vascular dementia and frontal-temporal lobe dementia.  

We know that chronic alcohol use can lead to dementia. 

Vascular dementia occurs as a result of a stroke. Long-term ethanol use increases blood pressure, increasing stroke risk. Alcohol consumption also increases the risk of developing type II diabetes, obesity, and atrial fibrillation. All of these increase the risk of stroke.

Alcohol abuse has also been associated with Alzheimer’s dementia:

“Research from the University of Illinois at Chicago has found that some of the genes affected by alcohol and inflammation are also implicated in processes that clear amyloid beta — the protein that forms globs of plaques in the brain and which contributes to neuronal damage and the cognitive impairment associated with Alzheimer’s disease.” 10 

Alcohol is bad for the brain. I want nothing to do with any avoidable habit that may lead to dementia.

What Alcohol is Doing to Your Body

Ethanol has an effect on every organ in the body. 

Take a look at this short youtube video on how drinking negatively affects the body:

https://www.youtube.com/watch?v=V2Aj-iJ6p38

 

Life Without Ethanol

Here are a few positive benefits of an ethanol-free life. Some of these have already been described earlier but will be repeated for emphasis.

  • Fewer calories consumed, which may lead to weight loss: It is no secret that alcoholic drinks contain empty calories. Drinking too much can derail any diet plan.
  • Better sleep quality: As mentioned above, ethanol disrupts REM sleep. This often leads to daytime sleepiness. If you combine this with a hangover, it leads to an awful day! 
  • More money to do the things you enjoy: Drinking is expensive, especially if you go to a bar. I once worked with a psychiatrist who told his patients to take half of the money they spent on their addictive substance (alcohol in this case), and spend it on something they enjoyed.
  • Improved interpersonal communication with family, friends, and colleagues: Nobody wants to be around someone who drinks too much. 

 

Michael Brown pictured with Final Thought written

Alcoholism is a significant problem in the United States. This disease leads to lost productivity, broken families, increased medical costs, and unnecessary pain and suffering. People have lost jobs, been involved in accidents, and gone through a painful divorce because of alcohol abuse.

Many drink booze to “have fun.” Is this making the situation more fun? Maybe you are having a good time because you are surrounded by people you like? Why not try to live without alcohol and see how you feel?

Ethanol does not make you sleep better. It changes your sleep patterns and robs your brain of restful REM sleep.

Think about the positives and negatives of drinking alcohol. If you think about it, drinking poison doesn’t make sense. Take it from someone who has eliminated it. You will feel better!

 It is possible to stop drinking. If you have a problem with alcohol, the most critical thing you can do is get help. Being healthy feels much better than being addicted to ethanol. Click on the following link for more information.

https://www.alcoholrehabguide.org/treatment/

This one-click may be the beginning of the healthiest thing you can do for your body! 

Don’t be shy.

You are in control of your life. 

You are responsible for your happiness, and only you can decide what goes into your body.

Eat right, exercise, get plenty of sleep, and do the things that make you happy!!

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Michael Brown in Lab Coat with arms crossed

Michael J. Brown, RPh, BCPS, BCPP

Mr. Brown is a Clinical Pharmacist specializing in pharmacotherapy and psychiatry.

Read Michael’s story here.

Feel free to send Michael a message using this link.

 

 
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